DBT Pros & Cons Worksheet Explained

This morning in one of our online DBT classes, one of our students shared how she used a DBT Pros and Cons worksheet to help her decide whether or not to go on a certain medication.

Coping with a physical ailment and having taken the prescription before, the student was aware of the potential benefits and side effects of taking it.  She rated her anxiety as 80 on a scale of 0-100 before filling out this sheet:
The most obvious distinction between the Pros and Cons list that many of us have made outside of DBT is that instead of having just two columns labeled "Pros" and Cons," there are two additional sections.

When you do this particular worksheet, you want to look at all of the following to help you make an informed decision.  This can be about any issue which has you feeling stuck and unable to decide:

1. The Pros of going with this decision (upper left square)
2. The Cons of going with this decision  (upper right square)
3. The pros of not going with this decision  (lower right square)
4. The cons of not going with the decision  (lower left square)

Initially, it may seem that 1 & 4 and 2 & 3 are similar -- and they are, but we find that when students list reasons from each of these perspectives, they come up with more insights to help them make a more well-rounded, Wise Mind decision.

The student in our example listed many pros of taking the prescription, such as how she knows it has worked in the past, it can help prevent her condition from progressing, and how it can prevent the need to take other, additional types of medications.

She also noted some side effects that she is aware of, including difficulty sleeping, heightened anxiety and mood swings, and weight gain.

After completing the Pros and Cons worksheet, she made the decision to take the medication.  Keeping all of the information in mind, she decided that the benefits outweighed the potential negatives, and she came up with self-empowering solutions to address her concerns, including: integrating more movement in her day, talking to her doctor about help with potential temporary insomnia, and reminding herself when she feels mood swings and anxiety that it is "just an effect of the medication" and nothing she needs to be alarmed about.

Upon completion of the sheet, she felt her anxiety level had reduced to a score of 30.  We think that's quite effective!


Have you ever used a pros and cons worksheet to weigh a decision?  Did you use the old fashioned two column version or one like this?  How might you use the DBT version to help you make a skillful decision?